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Abraham Verghese discusses stealing metaphors and the language of medicine at TEDMED

Abraham Verghese discusses stealing metaphors and the language of medicine at TEDMED

Abraham Verghese TEMED

Few of us pay close attention to metaphors used in the language of medicine. Instead, our focus is typically on words relating to symptoms, test results and diagnoses. But as Stanford physician and author Abraham Verghese, MD, explained last week at TEDMED in San Francisco (which was co-sponsored by Stanford Medicine), metaphors, particularly as they relate to medicine, are significant because “they explain our past… [and] share our present and, perhaps most importantly, the metaphors we pick predicate our future.”

Verghese took conference attendees through a “grand romp through medicine and metaphor” during a session titled “Stealing Smart,” which featured seven speakers and their stories on how stealing something from another field, such as the principles of video game design, could improve medicine. As a child with “no head for math,” Verghese was drawn to the written word and developed a love for metaphors. His physical and metaphorical journey into medicine originated with his childhood reading and, as he sheepishly admitted, his reading list “had a certain prurient bias.” In fact, he selected the novel that set the course of his life, Of Human Bondage by W. Somerset Maugham, because the title “had great promise.” Despite it’s lack of salacious content, the book made a lasting impression on Verghese.

He recalled reading about how the protagonist, a boy named Philip who was born with a clubfoot, overcame great adversity to become a physician. The character was intrigued at the variety of patients he meets in the wards of the hospital and marvels at their willingness to open up about their personal lives at a time of distress. In describing the doctor-patient relationship, the author writes, “There was humanity there in the rough.” Those words spoke deeply to young Verghese and “implied to [him] that not everyone could be a brilliant engineer, could be a brilliant artist, but anybody with a curiosity about the human condition, with a willingness to work hard, with an empathy for their fellow human being could become a great physician.” He added, “I came into [the profession] with the sense that medicine was a romantic passionate pursuit. I haven’t stopped feeling that way, and for someone who loved words anatomy was such fun.”

Verghese reveled in the abundance of medical metaphors throughout his training. The prevailing metaphor in anatomy was that of a house, while the overarching metaphor of physiology was that of a machine. When it came to describing symptoms, there was no shortage of metaphors: the “strawberry tongue” associated with scarlet fever, the “peau d’orange” appearance of the breast in breast cancer and the “apple-core” lesion of colon cancer. “That’s just the fruits – don’t get me started on the non-vegetarian stuff,” he joked.

But all of the metaphors noted in his talk are 60-100 years old, and when it came to naming one from more recent times Verghese was at a loss. He said:

In my lifetime, and I suspect in yours, we’ve seen so many new diseases – AIDS, SARS, Ebola, Lyme… We have so many new ways at looking inside the body and scanning the body, such as PET and MRI, and yet, strangely, not one new metaphor, that I can think of… It’s a strange paucity because we are so imaginative. The amount of science that has been done in the last 10 years eclipses anything that was done in the last 100 years. We’re not lacking in imagination, but we may be lacking in metaphorical imagination.

This dearth of metaphor has two consequences, he said. The first is that Congress isn’t funding biomedical research to the level that is necessary to advance new discoveries and treatments. The second is that patients are “not as enamored with our medicine and our science as we might think they should be,” he said. Verghese implored the audience to “create metaphors befitting our wonderful era discovery.” He encouraged those in the crowd and watching the livestream online to accept this challenge, saying, “I want to invite you to name things after yourself. Go ahead! Why not?”

As he closed the talk, Verghese shared the metaphor that has guided his life by saying:

It’s the metaphor of a calling. It’s the metaphor of a ministry of healing. It’s the metaphor of the great privilege we’re allowed, all of us with anything to do with health care, the privilege of being allowed into people’s lives when they are at their most vulnerable. It’s very much about the art of medicine. And we have to bring all the great science, all the big data, all the wonderful things that we’re going to be talking about [at this conference] to bear one human being to another… We have to love the sick. Each and everyone of them as if they were our own. And you know what? They are our own, because we are all humanity there in the rough.

Previously: Abraham Verghese urges Stanford grads to always remember the heritage and rituals of medicine, Inside Abraham Verghese’s bag, a collection of stories and Stanford’s Abraham Verghese honored as both author and healer

Events, Medical Education, Medicine X, Patient Care, Stanford News, Technology

Stanford Medicine X: From an “annual meeting to a global movement”

Stanford Medicine X: From an "annual meeting to a global movement"

MedX_musical_finaleAs Medicine X came to a close Sunday, ePatient and American Idol participant Marvin Calderon Jr. gave a special vocal performance that moved audience members to their feet and ended in an explosion of colorful streamers falling from the top of the main auditorium at the School of Medicine’s Li Ka Shing Center for Learning and Knowledge.

The three-day event, which was attended by more than 650 people and watched via live webcast by several thousand more, is Stanford’s premier conference on emerging health-care technology and patient-centered medicine. The conference hashtag #MedX was a top-trending term on Twitter in the U.S. throughout the conference, with more than 48,000  tweets sent out between Thursday and Sunday.

Medicine X has historically examined how social media, mobile-health devices, and other technologies influence the doctor-patient relationship. But this year, the program also focused on how partnerships forged between health-care providers, patients and pharmaceutical industry would define the medical team of the future, amplify patients’ voices, and shape medical education. Along with the topics of relationships and connectedness, a number of key themes emerged over the course of the conference, including engagement, empathy, and the imp0rtance of  treating the whole person.

Daniel Siegel, MD, clinical professor of psychiatry at UCLA, touched on several of these themes during his opening talk about developing a healthy mind, an integrated brain, and empathetic relationships. “Our relationships give us a sense of being seen, of feeling felt, of feeling connected. Those are the fundamental ways we create well-being in our bodily lives,” he said. “We live in connection to each other… Relationship experiences that are stressful early in life can lead to medical problems later.”

Several sessions put a special spotlight on the importance of treating the whole person and the link between mental and physical health. Patients shared their experiences with depression and anxiety, and many revealed how they had to grieve the loss of their healthy self in order to accept their new life. They also spoke about how they felt weakened by their mental-health condition and struggled to be empowered, or proactive, in their health care. Gonzalo Bacigalupe, EdD, MPH, a psychologist and professor of counseling and school psychology at the University of Massachusetts Boston, told patients, “Maybe the ‘e’ in ePatient is not enough. Maybe you need a ‘c’ that stands for connected. If you are connected, then the burden that you are feeling can be shared.”

Larry Chu and patient - smallSentiments about the need to foster empathy in medicine were discussed in parallel panels and during coffee break chats. Emily Bradley, an ePatient with a rare type of autoimmune arthritis, told attendees at a session about invisible pain, “I don’t fault my loved ones for not understanding my pain. I don’t want them to understand and I’m glad that they don’t. I think what’s missing is empathy.” Liza Bernstein, an ePatient advisor and three-time cancer survivor, told attendees at the closing ceremony, “Empathy doesn’t need that much. All empathy needs is us.”

The conference also tried to keep a focus on all different types of patient populations – including those who underserved. “There is a disconnect between solutions being build and the needs of vulnerable populations,” said Veenu Aulakh, executive director of the Center for Care Innovation during a talk on the “no smart-phone” patient. “We need to be designing [solutions] for today, not the future, and the 91 percent of patients that have a text-enabled phone.”

Larry Chu, MD, executive director of the conference (pictured above with Bernstein), warmly greeted the audience each morning – and on Saturday had a special announcement:  the launch of Medicine X Academy, a new effort aimed at continuing to build community among all stakeholders in health care and filling important gaps in medical education. The initiative will include a second conference in 2015 titled Stanford Medicine X ED (currently scheduled for Sept. 23-24, 2015). Joining Chu on stage to talk about the initiative, Bryan Vartabedian, MD, a Baylor College of Medicine physician and a longtime speaker at the conference, told attendees that medical education is “ripe for disruption.” And he noted that Medicine X – which has evolved “from an annual meeting into a global movement,” was poised to take it on.

Speaking of a global movement, there was very much a sense during the weekend that what was happening was bigger than just a conference – with at least one panel moderator telling attendees, “This conversation doesn’t end when we leave the stage.” And Bernstein summed up the three days of panels, presentations and powerful Ignite talks from ePatients saying, “I leave here re-energized, recharged, re-inspired and I hope you do too. Stay in touch on Twitter and see you next year!”

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Medicine X explores the relationship between mental and physical health: “I don’t usually talk about this”, At Medicine X, four innovators talk teaching digital literacy and professionalism in medical school, What makes a good doctor – and can data help us find one?, Medicine X aims to “fill the gaps” in medical education, Stanford Medicine X 2014 kicks off today and Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient
Photos by Stanford Medicine X

Events, Medicine X, Stanford News, Technology

Countdown to Medicine X: 3D printing takes shape

Countdown to Medicine X: 3D printing takes shape

3D printed handFrom customizing lab equipment to assisting in surgical planning to developing models of proteins and pathogens, 3D printing is helping to reshape biomedical research and health care. This year, Medicine X (which kicks off one week from today) will explore the transformative force of the technology during a range of panels and demonstrations in the “3D Printing and the Future of Medicine” session.

During the session, attendees will have the opportunity to learn more about health-care related 3-D printing applications at the “3-D Experience Zone,” which will showcase technologies from leading manufacturers. Attendees can learn about surgical applications of 3D printing from 3D Systems; find out how 3D Hubs is creating a global community by connecting owners of 3D printers with those who want to utilize the technology; and see how Occipital’s 3D scanning hardware for the iPad is supporting patient care. Additionally, they can discover how Artec creates a 3D full-body scan in a mere 12 seconds and enjoy chocolate and candy from the ChefJet food printer.

The session will also feature two Saturday-afternoon panels titled “Diverse Distributed & Design-Driven” and “Innovation Implementation,” with the latter exploring:

…some of the challenges and issues to consider in this brave new world. Will the FDA approve printed food, pharmaceuticals, and medical devices? How can 3D printing startups include patients in their design process? What are the public health implications when almost anyone can print biomaterials from the comfort of their own home? And once we ensure public safety, how can we make 3D printing affordable and accessible for all?

Darrell Hurt, PhD, computational biologist and project lead for the National Institutes of Health 3D Print Exchange, is among the panelists, and Monika Wittig, director and co-founder of Live Architecture Network, will moderate the discussions.

“As a designer, I am thrilled that this conference continues to widen the view of valuable cross-disciplinary collaborations. This is decidedly the aspect that I found most profound during my first Medicine X experience,” said Wittig. “My hope is attendees leave this session feeling a heightened awareness of 3D design and production technologies and the many realms of potential engagement in health sectors including prototyping, globally-distributed production and mass-customized design.”

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Countdown to Medicine X: Specially designed apps to enhance attendees’ conference experience, Countdown to Medicine X: Global Access Program provides free webcast of plenary proceedings, Countdown to Medicine X: How to engage with the “no smartphone” patient and Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation
Image of 3D printed hand from Medicine X

Events, Medical Apps, Medicine X, Stanford News, Technology

Countdown to Medicine X: Specially designed apps to enhance attendees’ conference experience

Countdown to Medicine X: Specially designed apps to enhance attendees’ conference experience

Figure 3 - BlanketLast year’s Stanford Medicine X conference explored ways in which technology could be used to augment the attendees’ experiences. During breaks between sessions, organizers used specially developed software to transform television screens set up in the lobby outside the main auditorium into interactive spaces where participants could exchange ideas. On one screen, attendees used their mobile phones to text their reflections on previous sessions or respond to prompts such as: “What’s your dream for health care?” The texts appeared as yellow sticky notes on a virtual corkboard. Another screen served as a digital journal where participants could text comments about what they learned and have them displayed to a wider audience. As people walked up to the screen to read the contextually relevant content, they naturally started conversations. In an effort to bridge the divide between the people who were physically present at the conference and those who were watching the live-stream from other locations, an additional screen broadcast tweets from around the world in real time.

This year, conference organizers have developed three iPhone apps for Medicine X based on Apple iBeacon, a Bluetooth-powered location system. “When we heard about the iBeacon technology, it was clear that it would fit really well into a conference setting as well as being useful for allowing people to interact with the large-screen displays,” said Michael Fischer, a PhD student in computer science in the MobiSocial Lab at Stanford, who helped develop the app. “We brainstormed all the possible ways that the iBeacon technology could help people participate in the conference and came up with some ideas that we are excited to test out at the upcoming conference.”

In anticipation of this year’s conference, I reached out to Fischer to learn more about how the apps will further enhance attendees’ experience at Medicine X. Below he explains how they will facilitate networking among participants, allow them to provide feedback or rate speakers and serve as a sort of “flight-attendant call button.”

Can you briefly explain how the apps work?

One app allows us to extend the Wellness Room, so that people can request items without having to go to the room and miss part of a session. The Wellness Room provides special amenities, such as warm blankets or a place to rest, to assist patients in managing their conditions during the conference. The room was designed to help patients physically attend the conference who might have otherwise not been able to. For example, a previous ePatient attendee had a medical condition called cryoglobulinemia, which causes proteins known as cryoglobulins to thicken if the ambient temperature drops too low. If this were to occur, it could lead to kidney failure and would be life threatening. So it’s crucial for this patient to keep warm. Using the iBeacon technology we were able to develop a system that allows people to use an iPhone to request a blanket or other item be delivered to their seat. There will be iBeacons on all the tables in the room so that the phone will automatically know where you are sitting. All the requests will be forwarded to a volunteer who will bring the item directly to the table.

Another app will be used during the breaks to help people get to know each other. The application works by displaying short bios on a nearby TV screen. In this way, the screen acts as a type of watering hole that people can gather around. When new people approach, their bios will be added to the screen. When a person leaves the proximity of the screen, the bio will be removed. We’ll have multiple screens set up around the conference. Our hope is that people can find a group that they might not yet be familiar with. The service is opt-in and people can switch to and from stealth mode at any time. Conference-goers will also have the option to forgo this app altogether.

Lastly, we have developed a feature that will be used at check-in. We want to create an experience that will surprise and delight people from the moment they step into the conference. There is a tradition at Stanford during freshman year that when you first come to your dorm, the dorm staff yells out your name. It is pretty big surprise and makes you feel part of the community instantly. We wanted to replicate that experience as best we could for the conference.

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Events, Medicine X, Stanford News, Technology

Countdown to Medicine X: Global Access Program provides free webcast of plenary proceedings

Countdown to Medicine X: Global Access Program provides free webcast of plenary proceedings

Those unable to physically attend next month’s Stanford Medicine X conference can participate in the event through the Global Access Program, which brings high-quality streaming video of the conference plenary proceedings, live photos and other updates to viewers’ desktop or mobile device. More details on the webcast can be found on the Medicine X blog:

The Global Access team is led by Emmy-award winning television producer Bita Nikravesh Ryan and 2013 Stanford-NBC Global Health Media fellow Hayley Goldbach. Our photography team includes Academy Award-winning documentary filmmaker Theo Rigby, speaker portrait photographer Christopher Kern, and our special venues photographer Yuto Wantanabe.

This year’s Global Access team also welcomes inventor and cancer researcher Jack Andraka.

To participate in the program, you will need to register on the conference website.  Keep in mind that the live stream does not include coverage of breakout sessions, pre-conference workshops, Master Classes or the IDEO Design Challenge.

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Countdown to Medicine X: How to engage with the “no smartphone” patient, Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation and Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient

From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.

Ethics, Events, Health Policy, Medicine and Society, Public Health, Transplants

Stanford Health Policy forum on organ-donation crisis now available online

Stanford Health Policy forum on organ-donation crisis now available online

The latest Stanford Health Policy Forum, which focused on ways to end our country’s organ-donor shortage, is now available online. More than 100,000 Americans currently need organ transplants, and the panelists discussed a variety of solutions for solving the problem. Among the ideas brought to the table was a compensation system for donors – an option that was also the focus of an article in today’s San Francisco Chronicle.

Previously: At Stanford Health Policy Forum, panelists dig into the issue of organ donationHow can we end the donor organ shortage?, Stanford visiting professor and founder of kidney-exchange program wins Nobel economics prize and One gift saves three young lives 

Ethics, Events, Health Policy, Stanford News, Transplants

At Stanford Health Policy Forum, panelists dig into the issue of organ donation

At Stanford Health Policy Forum, panelists dig into the issue of organ donation

Sally Satel, MD, was a practicing psychiatrist with a long history of scholarly research and policy-making in health care when a diagnosis of kidney failure popped her across the line that separates doctors from patients. Without a transplant or dialysis, the 16 percent of function left in her kidneys wouldn’t last long, and she became one of the 60,000 people in the U.S. waiting for a deceased donor kidney. That was in 2004.

One decade later, there are more than 100,000 people on that list. Last year, according to the National Kidney Foundation, just over 14,000 people received donated kidneys, a number that has remained flat since 2007. About 18 people die every day waiting on the list; another 12 are taken off the list daily because they have become too sick to survive transplant surgery. Satel was lucky – an acquaintance volunteered after others had bowed out – and Satel did receive a life-saving kidney transplant.

We need a transparent, safe and ethical system of exchange

From that unexpected experience, Satel wrote a book, ‘When Altruism Isn’t Enough: The Case for Compensating Kidney Donors,” to highlight the shortage. She also became a vocal advocate for changes in the organ donation system that could improve those increasingly dire numbers. This week, she joined a couple of thousand health professionals and interested others at the 2014 World Transplant Congress in San Francisco and also came here to participate in a Stanford Health Policy Forum on organ donation. She spoke alongside David Magnus, PhD, director of the Stanford Center for Biomedical Ethics, and Tom Mone, former president of the Association of Organ Procurement Organizations.

The forum was hosted by the office of Lloyd Minor, MD, dean of the medical school. “Our Health Policy Forums were created to serve as a platform for experts from Stanford and across the globe to discuss important and sometimes controversial medical topics,” he said in a post-event interview. “Our hope is that fostering dialogue on issues of critical importance to our clinicians and patients will take us one step closer to developing solutions.”

At the forum, moderator/Stanford professor Keith Humphreys, PhD, began the conversation by asking Satel what it was like being on the waiting list. “It was extremely difficult,” she answered. “You’re really put in a position of facing years of dialysis (and the wait for a deceased donor kidney) can be five years. In Los Angeles, it’s almost 10 years. The average person doesn’t survive that long.” Asking friends and family isn’t easy either, she said: “You are asking someone to give you a body part.”

Satel has proposed a system of rewards – “not, a check, but some sort of in-kind incentive like a contribution to a charity or a 401k,” she said. “We need a transparent, safe and ethical system of exchange.”

The ethics of such a compensation system is what worries Magnus, who told the audience:

Every time we’ve drawn a line — ‘Here’s what we think is acceptable’ — [it’s] almost always been erased and moved somewhere else… Because of the incessant drumbeat of need, there’s a tendency to move and move the line, and maybe those moves are okay and appropriate, but it makes the slippery slope very, very, very steep. We have had only two absolutes: the rule that prohibits taking organs while people are still alive and the prohibition of payment. Both of these principles are now under attack.

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Events, Medicine X, Mental Health, Stanford News, Technology

Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient

Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient

Larry_ChuInnovative thinkers and thought leaders engaged in using emerging technologies to enhance health-care delivery and advance the practice of medicine will gather here in early September for Stanford Medicine X.

As Lloyd Minor, MD, dean of the School of Medicine, comments in a release today, Larry Chu, MD, associate professor of anesthesia at Stanford and executive director of the conference, “has made this the go-to event for e-patients, physicians and innovators who want to get together to map out the future of health care.” Chu also notes that the conference  “has distinguished itself through a singular commitment to inclusivity and by finding new ways to bring every voice and perspective into important conversations about health care.”

Now in its third year, Medicine X is building on this inclusive spirit by exploring a variety of new themes during its 2014 program. More from our release:

This year’s program will spotlight the relationship between physical and mental well-being with three breakout panels. Psychologist Ann Becker-Shutte, PhD, will moderate a session on how mental health affects overall health. A conversation about emerging technologies in mental health will be led by Malay Gandhi, managing director of Rock Health, a business accelerator for health-care technology startup companies. Additionally, patient advocate Sarah Kucharski will direct a discussion about depression caused by chronic disease and about coping through online communities.

“Mental health is imperative to address in the overall conversation about the future of health care,” said Chu. “We need to be thinking about the health of the whole person, not just a patient’s individual symptoms or disease.”

The three-day event will also feature panels on what the medical team of the future may look like; how patients with chronic diseases can use self-tracking tools to improve their health and support one another; ways for the pharmaceutical industry to partner with patients in the drug discovery and clinical trial process; and opportunities to connect with “no-smartphone” patients — those who don’t have the access or resources to fully engage with health-enhancing technologies.

Keynote speakers for this year’s conference, being held Sept. 5-7, include Daniel Siegel, MD, clinical professor of psychiatry at the University of California-Los Angeles; Barron Lerner, MD, PhD, professor of medicine and population health at New York University School of Medicine; and Charles Ornstein, a Pulitzer Prize-winning journalist and senior reporter at ProPublica.

For information about the program or to  register the Medicine X website. Last year’s conference sold out, and space is limited for this year’s event.

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Medicine X Live! to host Hangout on design thinking for patient engagement, Quite the reach: Stanford Medicine X set record for most number of tweets at a health-care conference, Videos from Medicine X now available and “You belong here”: A recap of Stanford Medicine X
Photo of Larry Chu by StanfordMedicineX

Ethics, Events, Health Policy, Stanford News, Transplants

How can we end the donor organ shortage?

How can we end the donor organ shortage?

organ donorOur country’s organ shortage is an issue of critical importance – especially to the more than 100,000 Americans currently waiting for an organ transplant. In the words of Stanford’s Keith Humphreys, PhD, “Everyone agrees that 18 people dying each day on transplant waiting lists is unacceptable, but there is fierce disagreement about what to do about it.”

Next week, Humphreys will moderate a panel discussion that delves into the issue. He’ll be joined by three experts – including Stanford bioethicist David Magnus, PhD – who will discuss the effect of the organ donation on our country’s overall health and debate the ethical and practical aspects of proposals to solve the problem. Among the most controversial proposed approach and something that will be vigorously debated: paying people to donate their organs.

The event, part of Stanford’s Health Policy Forum series, will be held on July 28 at 11 AM at the Li Ka Shing Center for Learning and Knowledge, in room LK130. For those local readers: It’s free and open to the public, but space is limited. More information can be found on the forum website.

Previously: Students launch Stanford Life Savers initiative to boost organ donation, Full-length video available for Stanford’s Health Policy Forum on serious mental illness, Stanford forum on the future of health care in America posted online and Stanford Health Policy Forum focuses on America’s methamphetamine epidemic
Photo by Mika Marttila

Events, Medicine and Society, Stanford News

On death and dying: A discussion of “giving news that no family members want to hear”

On death and dying: A discussion of "giving news that no family members want to hear"

The standing room only crowd at the Stanford Humanities Center had come to hear physicians read their own writing about the most difficult of topics: “I Am Afraid I Have Bad News: Death and Dying in Medicine.” The enthusiastic response to the topic demonstrated the interest in and need for such a forum. “This is a topic we just don’t talk about enough, in medicine and in society,” said Ward Trueblood, MD, a member of Stanford’s Pegasus Physician Writer’s group who curated the event.

Trueblood’s own experiences as a trauma surgeon, particularly during the Vietnam War, affected him deeply. “When I went to medical school, they didn’t teach you about death and dying,” he explains. Trueblood has found writing to be a powerful way to process his experiences. His memoir, Blood of the Common Sky: A Young Surgeon in Vietnam, will be published this year, and his book of poetry To Bind Up Their Wounds is available on Amazon. Trueblood appreciated being able to give fellow physicians an opportunity to share their experiences with death and dying through personal poetry and essays.

Gregg Chesney, MD, a critical care fellow, read two poems, including “Lost in Translation”:

In trying to explain how “she hit the floor with a thud”

now means “she never woke up

and never will,” something was lost.

Yes, that is her heart tracing its beat across the monitor, but that swollen tangle

of blood, wrapped and knotted at the base of her brain

has pressed the leafless stalk of her medulla and left her

brain dead.  There is no one-more-test, no

chance-for-recovery, but at 2am, rendered in secondhand Mandarin,

that point might be missed, or left to dangle precariously,

soured and unplucked,

as he works out how to raise a 3 year-old on his own.

As Chesney finished the poem, his six-month old son cooed in his mother’s arms. The irony of the moment was not lost on the audience, as they contemplated the fate of the young father in Chesney’s poem.

Bruce Feldstein, MD, Stanford’s hospital chaplain, read “At My Father’s Bedside,” in which he shared what he had learned from his patients with his dying father:

The moment itself is peaceful, I’m told. No fear. Simply letting go. Smooth, like a hair being pulled from milk… You know, we human beings have been dying for a long time. Your body has a natural wisdom built right in for shutting itself down. The body knows just what to do. And there are medicines along the way to keep you comfortable.

During the Q&A session, an audience member asked Feldstein if there was anything he wished patients knew about their physicians. “Yes, how much doctors care,” Feldstein responded. “And that this effects them too. How difficult it can be to be the medical professional in that instance, giving news that no family members want to hear about their loved one.”

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